Mental Health Services: An Overview
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Mental Health Services: An Overview

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Mental health disorders, which profoundly disrupt a person's thinking, feeling, moods, ability to relate to others, and capacity for coping with the demands of life, are common in the US and abroad. About 26% of all Americans older than age 18 suffer “from a diagnosable mental disorder in a given year." If we one apply this to the 2004 US census for ages 18 and older, this would mean a 57.7 million people. It is significant that 6% of the population suffer from a disabling mental illness.

One in five Americans will have a mental illness during their lifetime that is severe enough to require treatment, and many more will experience problems that prevent them from enjoying their lives. Furthermore, mental illness accounts for more than 15% of death and disability in this country, more than that caused by all cancers.

Even though treatments for mental illnesses today are highly effective (70% to 90% of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacologic and psychosocial treatments and supports), nearly two-thirds of all people with diagnosable mental disorders do not seek treatment. Stigma surrounding mental health treatment and cost are among the barriers that discourage people from obtaining care.

If individuals with a mental disorder get the treatment they need, especially if it is early, many will fully recover from their disorder or be able to successfully control their symptoms. Below is an overview of mental health services and treatment options available to help you or someone you know with a mental health disorder take action.

I Think I Need Help, Where Can I Go?

Although mental health disorders can be debilitating, there is hope for those who suffer from them. First, it is important to be able to recognize symptoms of mental illness. Some of the most common and disabling manifestations to look out for are:

  • Feeling like your life is hopeless and you are worthless
  • Wanting to end your life
  • Feeling anxious
  • Being afraid of common things
  • Being very shaky, nervous, continually upset, and irritable
  • Doing things over and over again
  • Hearing voices in your head or seeing things you know that aren’t there
  • Feeling like you want to hurt yourself physically

If you think you might need help (particularly if your feelings and experiences are overwhelming), there are a number of places you can turn to and things you can do to ease the situation. The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends that you:

  • Arrange an appointment with your doctor, or other healthcare provider, or with a mental health agency. If your symptoms make you a danger to yourself or someone else, insist on immediate care and treatment. A family member or friend may need to do this for you if your symptoms are too severe.
  • Ask friends or family members to take turns staying with you until you feel better. Then talk, play cards, watch a funny video together, listen to music. Do things that keep you from feeling any worse and that may give you some relief.
  • Do some simple things that you usually enjoy like reading a good book, viewing a beautiful picture, playing with your pet, or writing in your journal.

For information about resources available in your community, a good place to start is SAMHSA’s Mental Health Services Locator, which allows you to find what’s available in your state. In addition, you might want to contact your local mental health center (the National Council for Community Behavioral Health Care can help you locate a community mental health center in your area) or an affiliate of a national self-help organization (such as the National Alliance for the Mentally Ill or the National Empowerment Center), which will tell you about services designed to meet your specific needs.

Keep in Mind

Mental illnesses can affect persons of any age, race, religion, or income. They are not caused by weakness, lack of character, or poor upbringing. And yet, stigmatization of people with mental disorders persists. Don’t let this stop you from seeking the care you need.

The consequences for people with a mental health disorder who fail to obtain treatment include disability, unemployment, substance abuse, homelessness, inappropriate incarceration, or suicide. The sooner you get help, the sooner you will feel better.

Treatment Options: A Brief Summary

Many mental health conditions can be effectively treated with one or a combination of the therapies listed below. Treatment emphasis over the past decade or so, however, seems to have shifted from psychotherapy to pharmacologic therapy.

A study published in the Journal of the American Medical Association examined trends in outpatient treatment for depression (a major type of mental illness). The study found that between 1987 and 1997, there was a significant increase in the number of Americans who received treatment for depression. Over that period, however, treatment with antidepressant medications increased significantly, while the proportion of patients who received psychotherapy declined significantly, along with the number of psychotherapy visits per patient.

Psychotherapy

Psychotherapy (or “talk therapy”) is a learning process in which mental health professionals help individuals who have mental health disorders through the exchange of verbal communication. The three major types of psychotherapy are:

  • Psychodynamic: The role of the past in shaping the present is emphasized to try to understand a person’s behavior (how people come to act and feel as they do, including the influences of which people are not aware).
  • Behavioral: This type of therapy focuses on the patient's current behavior patterns rather than on early behavior patterns.
  • Humanistic: Also known as existential, experiential, or Gestalt therapy, humanistic therapy focuses on the immediate experience of the client.

Pharmacological Therapies

In recent years, there has been an outpouring of new medications introduced for the treatment of mental health disorders. These include:

  • Antipsychotics (neuroleptics)
  • Antidepressants
  • Stimulants
  • Antimanic
  • Anti-anxiety (anxiolytics)
  • Cholinesterase inhibitors

If you need pharmacologic therapy, your doctor will be able to determine which type of medication is right for you.

In some severe cases, electroconvulsive therapy (ECT) may be used.

Payment Methods for Mental Health Services and Treatments

There are many options for payment of mental health services and treatments.

If You Have Private Insurance

Health plans vary in terms of what they cover. Find out what treatments and services your plan covers or shop around if you are in the process of selecting a plan.

If you are not satisfied with your mental health benefits, the American Psychiatric Association recommends that you talk to your employee benefits manager or union representative to try to improve your coverage.

If You Are Underinsured or Uninsured

There are several resources available to people who don’t have health insurance or to those looking for care their plan doesn’t cover:

  • Public assistance (for the uninsured only): This includes Social Security (Disability Insurance and Supplemental Security Income), Medicare (a federal insurance program for people 65 years and above and some with disabilities under 65), and Medicaid (a federal and state insurance program that pays for healthcare for the poorest and most vulnerable Americans).
  • Community-based resources: Community mental health centers offer a range of treatment and counseling services. For people without private insurance, they generally require that you are a recipient of public assistance.
  • Pastoral counseling: Your church or synagogue may offer counseling, often on a sliding-scale fee basis.
  • Self-help groups: Such groups give people the chance to learn about, talk about, and work on common problems. They are generally free and can be found in virtually every community.
  • Sliding-scales: Many private practices offer sliding scales, so that individuals with financial need can still seek help. Always ask whether such an arrangement is available.

Asking for Help Is Not Easy

If you feel something is wrong, don’t hesitate to ask for help. It may not be easy, but it will be worth it. Chances are, with the right treatments and services, you will be able to recover from your mental health disorder.

RESOURCES:

National Alliance for Mental Illness (NAMI)
http://www.nami.org/

National Council for Community Behavioral Health Care
http://www.nccbh.org/

National Empowerment Center
http://www.power2u.org/

National Institute of Mental Health
http://www.nimh.nih.gov

Mental Health Services Locator
Substance Abuse and Mental Health Services Administration (SAMHSA)
http://www.mentalhealth.org/databases/

US Department of Health and Human Services: Substance Abuse and Mental Health Services Administration (SAMHSA)
http://www.samhsa.gov/

References:

About mental illness. National Alliance for Mental Illness website.
Available at: http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Mental_Illness/About_Mental_Illness.htm. Accessed July 14, 2003.

Mental disorders in America: the numbers count. National Institute of Mental Health (NIMH) website. Available at: http://www.nimh.nih.gov/publicat/numbers.cfm. Accessed July 14, 2003.

Mental health: a report of the surgeon general (1999). Available at: http://www.surgeongeneral.gov/library/mentalhealth/home.html. Accessed July 14, 2003.

Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pineus HA. National trends in the outpatient treatment of depression. JAMA. 2002;287:203-209.

Parity for mental illness health insurance. American Psychiatric Association website. Available at: http://www.psych.org/public_info/men_insurance.cfm. Accessed July 14, 2003.

People can recover from mental illness. National Empowerment Center website.
Available at: http://www.power2u.org/recovery/people_can.html. Accessed July 18, 2003.



Last reviewed July 2007 by Theodor B. Rais, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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